Hidradenitis suppurativa in a journey of an African refugee

As an African man who lived most of his life in Africa before immigrating to Ireland, I had a long journey trying to find answers before receiving a diagnosis of hidradenitis suppurativa.

When temporary relief is not worth the cost: a warning on using sunbeds to self-treat acne in teenagers

As a teenager, I struggled with severe cystic acne that caused low self-esteem, social anxiety and embarrassment. Desperate for a quick solution, I started regularly using tanning beds based on claims it could clear my skin. While my acne initially improved, I was unaware of the cumulative damage the UV rays from the tanning bed could have on my skin.

Specialty Certificate Examination case for general dermatology and dermatology in primary health care

A 53-year-old male patient was referred from the nephrology department with a 5-week history of an intensely pruritic rash affecting his trunk and the extensor surfaces of his arms and legs.

General dermatology and dermatology in primary care

A 73-year-old man was referred to the dermatology clinic with a 6-month history of a solitary red lesion on the right cheek. On examination there was a 12 × 6 mm nontender, flaccid, red thick-walled bulla on the right cheek with a firm nodular component. Histology demonstrated islands of basaloid cells with central abrupt keratinization, ghost cells and some fragmentation of the dermis. What is the diagnosis?

Multiple Eruptive Clear Cell Acanthomas Successfully Treated with CO2 Laser Ablation

Clear cell acanthoma (CCA) is a rare, benign epidermal lesion of clear glycogen-containing keratinocytes. The exact etiology is unknown. Although CCA usually appear as solitary lesions, cases of multiple CCAs have also been described. The rare eruptive CCA variant describes cases with more than 30 lesions.Current therapeutic evidence for the management of multiple CCAs is limited. CO2 laser remains the most widely used laser in clinical practice. However, literature describing its effectiveness on CCA is sparse, and previous reports have described its use for a maximum of three lesions. To our knowledge, this is the first report of successful CO2 laser treatment of the multiple eruptive CCA variant with an excellent cosmetic outcome.Our case adds to the evidence that CO2 laser is an effective treatment for this condition. Particularly in those patients with refractory or multiple eruptive CCAs, or for those who may not tolerate repeated courses of cryotherapy, or who are concerned about scarring and cosmetic outcome.

Muir-Torre syndrome: a case of unusual coexisting genetic mutations

Muir-Torre syndrome (MTS) is a rare autosomal dominant geno-dermatosis that was independently described by Muir in 1967 and Torre in 1968. MTS is a phenotypic subtype of Lynch syndrome and most commonly arises due to germline mutations in mismatch repair genes. MTS manifests with at least one cutaneous neoplasm and one visceral malignancy.

Endoluminal arterial injury in plasminogen-deficient mice

BACKGROUND

Vascular remodeling following arterial injury is characterized by an initial inflammatory reaction. Prior experiments using peritoneal inflammatory models have shown that the plasminogen system plays a role in the intensity of the inflammatory response. This study was undertaken to test the hypothesis that an absence of plasminogen would lead to a decrease in vascular remodeling.

METHODS

A left carotid artery injury was created with a flexible guidewire in both wild-type [Plg(+/+)] and plasminogen deficient [Plg(-/-)] mice. The right carotid artery was uninjured and used as a control. Three weeks postinjury, the mice were sacrificed and perfusion fixed, and the bilateral carotid arteries were sectioned for histological examination and collection of morphometric data.

RESULTS

After arterial injury, electron microscopy of the acutely injured artery revealed that the endothelium was denuded, that there were breaks in the internal elastic membrane, and that there was disruption of the medial layer of smooth muscle cells. The intimal and medial areas were significantly increased between the uninjured and injured carotid arteries of both Plg(+/+) (+80% intimal, +41% medial, P < 0. 05) and Plg(-/-) [+48% intimal, +24% medial, P < 0.05) mice. However, although there was a significant increase in the adventitial area of Plg(+/+) mice (+18%, P < 0.05), there was no difference in Plg(-/-) mice (-6%). Interestingly, even after 3 weeks, four of six injured arteries in Plg(-/-) mice had persistent thrombus within the medial layer, whereas this was not found in any of the nine Plg(+/+) mouse arteries.

DISCUSSION

Plasminogen deficiency inhibited the increase in adventitial area seen after injury in Plg(+/+) mice, but not the increase in intimal or medial areas. Not surprisingly, plasminogen-deficient mice also demonstrated a severe alteration in intramural thrombus clearance. Thus, specific aspects of the vascular remodeling response are dependent on plasminogen.